中南大学湘雅医院血液透析患者血管通路现状  

Investigation of status for vascular access in hemodialysis patients at Xiangya Hospital of Central South University

作　　者：钟永[1] 蒲佳曦 敖翔[1] 彭卫生[1] 彭张哲[1] 李晓照[1] 肖湘成[1] 周巧玲[1] 肖平[1] 

机构地区：[1]中南大学湘雅医院肾内科,长沙410008

出　　处：《中南大学学报（医学版）》2017年第11期1270-1274,共5页Journal of Central South University ：Medical Science

基　　金：国家自然科学基金(81402453);湖南省自然科学基金(2015JJ4058);湖南省发展和改革委员会课题(湘发改高技[2013]1199)~~

摘　　要：目的:了解血液透析患者的血管通路现状。方法:回顾性分析中南大学湘雅医院血液透析中心2015年4月1日至2016年4月1日新导入及维持性血液透析患者的基本资料、血管通路选择和并发症。结果:维持性血液透析患者258例,采用自体动静脉内瘘(artetiovenous fistula,AVF)的患者占87.60%、带涤纶套带隧道导管占12.40%。新导入患者61例,首次透析采用无隧道无涤纶套导管的患者占80.33%,AVF占8.19%,带涤纶套带隧道导管占9.84%,动静脉穿刺占1.64%。AVF选择吻合血管依次为腕桡动脉-头静脉(76.55%)、肱动脉-头静脉(11.06%)、前臂中段桡动脉-头静脉(7.08%)、肱动脉-肘正中静脉和肱动脉-贵要静脉(5.31%)。AVF发生并发症占总AVF透析人数的34.07%,其中动脉瘤占24.34%。结论:维持性血液透析患者绝大多数采用AVF,而新导入透析患者中使用无隧道无涤纶套导管者比例较大。Objective： To investigate the status of vascular access in hemodialysis patients in our center. Methods： The general information of hemodialysis patients and types and complications of vascular access at Xiangya Hospital of Central South University from April 2015 to April 2016, were retrospectively analyzed. Results： Among 258 prevalent patients, 87.60% of them had arteriovenous fistula （AVF）, while 12.40% showed tunneled cuffed catheter. Of the 61 incident patients, 80.33% of them initiated dialysis with a non-tunneled and non-cuff ed catheter, 8.19% with an AVF, 9.84% with a tunneled cuffed catheter, and 1.64% with needle puncture. The types of AVF access included 76.55% of wrist radiocephalic fistula, 7.08% of mid-forearm cephalic fistula, 11.06% of elbow brachiocephalic fistula, and 5.31% of antecubital fistula and transposed basilic fistula. Seventy-seven （34.07%） patients with AVF suffered complications and wherein aneurysms accounted for 24.34%. Conclusion： In maintenance hemodialysis patients, autologous AVF is the prevalent vascular access. In the beginners for dialysis, non-tunneled and non-cuffed catheter are their choice. Additional efforts and incentives may be necessary to improve vascular access during the initiation of hemodialysis.

关 键 词：血液透析 血管通路 并发症 

分 类 号：R459.5[医药卫生—治疗学]